Nordisk medicin最新文献

Prevalence studies have shown cognitive and affective disorders to be common in multiple sclerosis (MS). Although much is known about the manifestations of such disorders, our knowledge of the cerebral systems involved remains poor. Functional techniques will enable cerebral blood flow to be measured, and sophisticated SPECT (single photon emission computed tomography) techniques can provide a clearer picture of the dynamics of cognitive and affective processes in MS. Increased knowledge of these disorders would enable the management and rehabilitation of MS patients to be improved.

Of the approximately 300,000 diabetics in Sweden, about 15 per cent have type I or juvenile diabetes, and the remainder type II or diabetes of maturity. Naturally, this is a gross oversimplification of the situation, and reflects our predilection for classification rather than our knowledge of the etiology and heterogeneity of the disease. Not only is there a broad indeterminate zone between the two main types, but during recent years a number of genetically determined forms have also been described. Accordingly, the World Health Organisation has recently proposed changes in the classification of diabetes and in the diagnostic criteria. The new proposals are reviewed in the article.

As phototoxic and photoallergic reactions have been recognised as unwanted skin manifestations caused by any of several hundred substances, drugs and chemicals, it is essential to determine the potential photo-sensitising properties of such substances before they are introduced in clinical therapy or made available on the market, in order to avoid such reactions. In cases of phototoxic reactions, the patient presents with skin changes resembling sunburn, sometimes accompanied by blistering, whereas in cases of photoallergic reactions the skin changes are similar to those of allergic contact dermatitis. The two most important aids to clinical investigation are determination of the erythema treshold, or the minimal erythema dose, and photopatch testing. The article reviews the basic mechanisms of photosensitisation, outlining the most important differences between phototoxic and photoallergic reactions, summarises the most frequent photosensitisers, and presents the diagnostic procedures, including the tests used in experimental phototoxicity.

During the last 10-15 years allergic reaction to Natural rubber latex (NLR) has become an increasing occupational problem among health-care workers. The allergy is caused by allergenic proteins in the NRL. The diagnosis is achieved through a relevant history, skin prick tests with aquous NRL glove extracts and blood tests. History and prick tests are most important. The most frequent cross-reaction is to banana. Careful instruction on prevention is a must.

The question often arises of how health status is to be measured, or to what end. A number of instruments have been developed for the measurement of patient health, and the article consists in a review of the methodology and specific applications of some of those most commonly used, as outlined in published reports. The review showed the defined goal (s) of investigation to constitute a crucial determinant of the choice of methods, as most of the available instruments are designed for specific situations or categories of patients. Thus, an unfortunate choice may result in sufficient or erroneous data for the purposes of decision making.